Stop headaches, back pain and more

Beat your top health woes: The latest on handling the issues that plague women most

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A couple of weeks ago, I met up with two friends for dinner. Between talk of my aching legs, Melissa’s heartburn and Sarah’s allergies, you’d have thought we were retirees there for a Golden Girls reunion, not a bunch of healthy, gymgoing women in our 30s out to have fun. But we’re far from unusual. In fact, women all across America say they feel “unhealthy” an average of four days a month, according to the Centers for Disease Control and Prevention in Atlanta. We’re not talking about serious, life-threatening illnesses: We mean those assorted aches and pains that may be just bad enough to make you drag through the day, cancel a date or call in sick. Naturally, SELF wanted to know what’s bringing you down. One in five readers said mild depression and anxiety sideline her most. (Check out “The Hidden Signs of Depression.”) The next most common complaints—allergies, headaches, back, shoulder and neck pain, painful periods and constipation—together accounted for nearly two thirds of the responses. That’s why we decided to go straight to leading women’s-health experts for surefire prevention strategies and the latest treatment advice, so you can get on with living—and loving—your life!

1. Allergies

Every spring and fall, more than 10 million American women transform from productive citizens into foggy-headed, drippy-nosed eye scratchers. But it’s not only because of hay fever: Reactions to dust mites, animal dander and mold can also make you feel as if you have a never-ending head cold. “As soon as allergies start getting in the way of sleeping, working or playing, it’s time to get help,” says Kathleen Sheerin, M.D., an allergist at the Atlanta Allergy & Asthma Clinic.

Your prevention plan The first step is to note where you are and what you’re doing when symptoms occur. (Download a log here.) Next, turn your bedroom into a hypoallergenic sanctuary: If you wake up stuffy, try special allergen-blocking covers for your mattress, pillows and duvet; they can protect you from dust mites, which thrive inside bedding. Check local pollen conditions at Pollen.com and keep your windows shut when the count is high, Dr. Sheerin suggests. Change the filter in your air conditioner and/or run an air purifier in your bedroom to help clear the air. And keep things clean. Although vacuuming your carpet, disinfecting the bathroom and washing your sheets weekly is a pain, you’ll see a difference.

Flare-up fixers Luckily, there are medications that will clear you up without conking you out. The active ingredient to look for in over-the-counter meds is loratadine, Dr. Sheerin says. It doesn’t cause the drowsiness that older drugs can. If you need something more potent, a prescription-strength antihistamine or a steroid nasal spray may be in order. But bear in mind that many insurance companies require a doctor’s letter saying you’ve tried OTCs to no avail before they will cover Rx meds.

Breaking news Allergy shots may soon be less of a pain, thanks to a new long-lasting vaccine recently tested on hay fever patients. According to a study in The New England Journal of Medicine, patients found that their allergy symptoms were controlled through two ragweed seasons after only six weekly injections. Older versions require at least 12 to 24 rounds.

2. Headaches

Because of the combination of everyday stress and fluctuating hormones, women in their 20s and 30s get three times more headaches than men. In fact, up to 60 percent of the women who suffer migraines in particular can link them to their period. And yet doctors still don’t quite understand the relationship. Some women have more migraines when estrogen levels are rising, at the beginning of the cycle; others have them when estrogen falls, before their periods; and some are prone at both times, says Stephen Silberstein, M.D., professor of neurology at Thomas Jefferson University in Philadelphia.

Your prevention plan “Go to bed at the same time every night, eat regular meals and exercise,” advises Dr. Silberstein, who says an erratic schedule can exacerbate pain. Tossing cigarettes and cutting down on caffeine and alcohol can also help, as can tracking your diet to see if any foods bring on your pain. (Find a log here.) Red wine, aged cheeses and MSG are among the most common offenders.

Once you get a handle on these lifestyle issues, consider your birth control. The Pill eases some women’s headaches, yet worsens others’, Dr. Silberstein says. It may take some trial and error, so ask your gyn about different options.

Flare-up fixers If garden-variety pain relievers are no match for your headaches, your doctor might prescribe one of the triptan drugs, which you take at the first sign of a migraine. They are effective in 80 percent of patients. There are reliable pill-free options, too: Relaxation exercises have been shown to reduce headache pain (try the meditation CDs at Headaches.org). And in a study of patients who had no luck with conventional treatments, 84 percent said their symptoms were eased after low-dose injections of Botox in the forehead and neck, according to researchers at Wake Forest University in Winston-Salem, North Carolina. Be warned: Your insurance probably won’t cover them, and they start at around $350.

Breaking news The future of migraine treatment may one day include occipital nerve stimulation, in which a small device is implanted under the skin in the back of your head. It then sends out electrical signals that block pain.

3. Back, shoulder and neck pain

If you think about all the ways we abuse our back, neck and shoulders—sitting hunched over a desk, carrying handbags big enough to house a family of four, wearing stylish but unsupportive shoes—it’s a wonder we can stand up straight at all. In a survey by the North American Spine Society in LaGrange, Illinois, 64 percent of women say back pain has interfered with working, sleeping, driving, even having sex. Along with slouching, carting and teetering, biology can be blamed for your back and neck pain: The disks—the shock absorbers between the vertebrae—are 90 percent water. Around age 30, they start to compress, raising your risk for pinched nerves, herniated disks and joint pressure.

Your prevention plan Exercise, exercise, exercise. Your regimen should include moves that focus on core strength. If you’re a desk jockey, get up every hour for a five-minute break. “Sitting for long hours can be stressful to the joints and muscles that stabilize the spine,” says Emile Hiesiger, M.D., clinical associate professor of neurology and radiology at New York University Medical Center in New York City. He also suggests swapping that giant handbag for a smaller one with a loop just long enough to fit over your shoulder. Do you lug around a laptop or a diaper bag? Try to switch shoulders every other day.

Flare-up fixers If you’ve had consistent back, neck or shoulder pain for more than six weeks, see a doctor to rule out serious problems such as a fracture. You may have a herniated disk, a fairly common problem in young women that often heals on its own. In the meantime, you can get relief with a prescription (usually nonsteroidal anti-inflammatory drugs—NSAIDs—or mild narcotics), injections, or even transcutaneous electrical nerve stimulation, in which electrodes placed on your back trigger the release of pain-relieving endorphins.

If the doctor determines that your pain is primarily muscular, the single most effective way to get better and stay better is to exercise, says Carol Hartigan, M.D., assis
tant clinical professor at Harvard Medical School in Boston. “Most people avoid working out the muscles that are bothering them, but studies have demonstrated that exercising through the pain is not only safe, it reduces pain and improves function,” she says. Movement increases circulation to the area, delivering oxygen and nutrients while clearing out toxins. But Dr. Hartigan cautions that you should ease into a routine that focuses on back health and work with a doctor or physical therapist who is specially trained in spinal care. (You can find one at Spine.org or AAPMR.org.) This isn’t a time to go it alone.

Breaking news If your doctor decides you’re a candidate for pain-relieving shots, ask her if she can administer them using fluoroscopy, an X-ray-guided technique. It can make the injections much more accurate—and much more effective.

4. Period cramps

Nine out of 10 women have cramps at some point. “And many silently suffer,” says Nanette Santoro, M.D., a gynecologist at Albert Einstein College of Medicine in Bronx, New York. That’s hardly surprising considering that most of us are taught that period problems are simply part of being female, like childbirth and waxing.

Your prevention plan Frankly, the best way to eliminate period pain is to eliminate your period. There are two ways to do that: First, you can get pregnant. Of course, no one would ever suggest you take on motherhood simply to cure your menstrual woes, but when and if you are ready to have a baby, there’s a good chance your cramps will disappear for good. “It seems that when cramping occurs, blood flow to the muscle is interrupted. It’s like the uterus is having a little heart attack,” Dr. Santoro explains. But after pregnancy, the uterus may become better vasculated and have a better blood supply. The other (more practical) way is to go on an extended-regimen oral contraceptive, Dr. Santoro says. These not only limit the number of periods you get but also dial down the pain that accompanies them. And with progesterone-only contraceptives such as Depo-Provera or the Mirena IUD, you may get very light periods or no period at all. No period equals no cramps.

Flare-up fixers Applying a heating pad can help, but taking an NSAID will make you more comfortable. In addition to killing the pain, these drugs reduce the production of prostaglandins, the hormones responsible for the uterine contractions.

Breaking news If you use birth control pills, ask your doctor about whether you should insert them vaginally. Some studies have shown that this method eases pain more effectively than when they are taken orally—and they still prevent pregnancy.

5. Intestinal problems

We know it’s not exactly enjoyable to discuss bathroom habits, especially constipation. But really, there’s nothing to be ashamed of—and not asking for help when you need it can lead to bigger problems later. Constipation is much more common in women than men, possibly because women have longer colons. Plus, monthly hormone fluctuations can affect the movement of food through your gastrointestinal tract. “Before your period, you may be constipated for a few days. Then on the day you get your period, you may have a looser stool,” explains Cynthia Yoshida, M.D., a gastroenterologist in Charlottesville, Virginia.

Your prevention plan It’s pretty simple: Eat regular, fiber-rich meals (aim for 25 grams a day), work out and drink plenty of water, Dr. Yoshida says. It’s also critical that you get over any issues you may have with using public toilets. The longer you don’t go, the worse your constipation may become.

Flare-up fixers For acute bouts, doctors recommend a step-up regimen of treatments. First, add fiber to your diet. Start with 5 grams a day and increase by 5 grams every four or five days until you get to 25 grams. Whole grains and uncooked fruits and vegetables are great sources. You can also try a fiber additive, such as Citrucel or Metamucil (though it’s crucial to drink more water if you are taking fiber supplements). If that doesn’t do the job within two weeks, try a stool softener such as Colace, a saline laxative such as Milk of Magnesia or even an enema. If you’re still not going after two more weeks, you may need more intensive intervention, Dr. Yoshida says. Your doctor might prescribe a laxative to help keep your system in working order. The longer you’re blocked, the more likely your brain is to become desensitized to signals that the colon is full.

Breaking news Physical therapy can help. “Some people actually learn to have a bowel movement incorrectly,” Dr. Yoshida says. “Instead of relaxing their external anal sphincter, they squeeze it.” Your doc can refer you to a physical therapist trained in biofeedback who will teach you how to use the muscles. Don’t let embarrassment hold you back—you’re smart to take charge of your own health!